经睫状体平坦部20G免缝合硅油取出术的临床效果

SILICONE OIL REMOVAL BY 20G SUTURELESS PARS PLANA SURGERY

目的比较经睫状体平坦部20G免缝合硅油取出术与常规20G缝合切口硅油取出术的临床疗效。方法对单纯有晶体眼硅油取出术病人59例(59眼)进行回顾性分析,其中经睫状体平坦部20G免缝合切口硅油取出术30眼(20G免缝合组),常规20G缝合切口硅油取出术29眼(20G缝合组)。比较两组平均手术时间、术后最佳矫正视力(BCVA)、眼压、病人舒适度及并发症情况。结果 20G免缝合组与20G缝合组相比,巩膜切口建立时间和关闭时间均缩短(t=1.788、1.805,P<0.05)。术后1d免缝合组BCVA优于缝合组(t=1.743,P<0.05),术后1周、1个月及3个月两组BCVA差异均无统计学意义(t=0.478～0.661,P>0.05)。两组术后1d眼压均低于术前,差异有显著性(t=1.782、1.847,P<0.05)。20G免缝合组术后患眼疼痛不适及眼红外观持续时间较缝合组明显缩短(t=5.884、5.952,P<0.01)。结论经睫状体平坦部20G免缝合硅油取出术安全有效,且术后病人舒适度高、恢复快。

Objective To investigate the clinical effects of silicone oil removal by 20G sutureless pars plana surgery ver- sus routine 20G pars plana surgery. Methods Fifty-nine consecutive patients （59 eyes） undergoing single silicone removal were collected, and divided into 20G sutureless pars plana surgery group （20G sutureless group, 30 eyes） and routine 20G suture pars piano surgery group （20G suture group, 29 eyes）. The average operation time, best corrected visual acuity （BCVA）, intraocular pressure, patient＇s degree of comfort and complications after surgery were recorded and analyzed. Results Compared with 20G suture group, 20G sutureless group was faster in building and dosing scleral incisions （t = 1.788,1.805;P 〈0.05）. BCVA in 20G sutureless group was better than that in 20G suture group one day after surgery （t=1.743,P〈0.05）, and that was no significant difference after one week, one month and three months after （t = 0.478--0.661, P〉0.05）. IOP one day after surgery in both groups was lower than preoperative, the difference being significant （t = 1.782,1.847;P 〈0.05）. The duration of discomfort and red eye appearance look in sutureless group was shorter than that in suture group （t = 5. 884, 5. 952; P 〈 0. 01）. Conclusion Pars piano silicone oil removal with 20G sutureless vitrectomy is effective and safe, with an advantage of high degree of comfort and fast postoperative recovery.